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Prostate-specific antigen screening at low thresholds of men with pathogenic BRCA1/2 variants

  • 0Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. hein.vincent.stroomberg@regionh.dk.
Prostate Cancer and Prostatic Diseases +

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January 21, 2025

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January 21, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Men with BRCA1/2 variants have a high prostate cancer incidence. A low PSA biopsy threshold identified cancers but recurrence risk after treatment is concerning and needs further study.

Area Of Science

  • Oncology
  • Genetics
  • Urology

Background

  • Men with pathogenic BRCA1/2 variants have an increased risk of prostate cancer.
  • Cascade germline testing identifies individuals with these variants.
  • A prostate-specific antigen (PSA) screening program was established for these men.

Purpose Of The Study

  • To evaluate the effectiveness of a low PSA threshold for biopsy in men with BRCA1/2 variants.
  • To assess prostate cancer incidence and outcomes in this high-risk population.

Main Methods

  • A cohort of 340 men with likely pathogenic/pathogenic (LP/P) BRCA1/2 variants were enrolled in a PSA screening program from 2014 to 2023.
  • Yearly PSA testing and an age-specific low PSA threshold for biopsy were employed.
  • Demographics, clinical characteristics, and treatment outcomes were analyzed over 7 years.

Main Results

  • The cumulative incidence of primary biopsy was 37% after 7 years.
  • Prostate cancer was diagnosed in 11% of participants, a 7.8-fold increased likelihood compared to the general Danish male population.
  • Biochemical recurrence after radical prostatectomy (RP) occurred in 22% of men within 4 years.

Conclusions

  • Men with LP/P BRCA1/2 variants exhibit a high incidence of prostate cancer, potentially influenced by the low PSA biopsy threshold.
  • The observed high risk of recurrence after curative therapy warrants further investigation into potential biological factors.
  • Additional research is needed to compare outcomes in this population with men possessing other germline predispositions.